AFS 250 Market Snapshots Webinar Friday, July 27, 2018 Jonathan Chapman , Director of CHC Advisory Services , Capital Link
Capital Link • Launched in 1995, nonprofit, HRSA national cooperative partner • Offices in CA, CO, MA, ME, MO, SC and WV • Over $1.1 billion in financing for over 230 capital projects - Direct assistance to health centers and complementary nonprofit organizations in planning for and financing operational growth and capital needs - Industry vision and leadership in the development of strategies for organizational, facilities, operational and financial improvements - Metrics and analytical services for measuring health center impact, evaluating financial and operating trends and promoting performance improvement 2018 Capital Link www.caplink.org 2
CCALAC Advancing Financial Strength (AFS) Program Overview Not a “ CFO Training Program ” but an integrated learning experience. Support CFO/Finance CEO/COO Team Staff CMO/ Board Clinical Members Team 2018 Capital Link www.caplink.org 3
Goal: Financial Sustainability and Access to High Quality Care Staffing Financial Productivity Operations Improved Access & Financial Sustainability Patient Utilization Satisfaction Clinical Outcomes 2018 Capital Link www.caplink.org 4
Today’s Agenda • Market Snapshots - Defined • Using the Data Already at Hand • “Back of the Envelope” Calculations 2018 Capital Link www.caplink.org 5
Why a Market Assessment? 2018 Capital Link www.caplink.org 6
Assess and Manage Risk on the Edge… 2018 Capital Link www.caplink.org 7
Market Assessment 2018 Capital Link www.caplink.org 8
Things to Consider Before You Start • What is your perceived Market? • Market can = geography, specific population, service type, etc. • The resulting data will likely inform & expand any ‘gut instinct’ • There is A LOT of data out there • Reviewers may occasionally have a differing opinion 2018 Capital Link www.caplink.org 9
Capital Link’s Typical Table of Contents • Health Center Overview • Service Area Identification • Service Area Description • Comparative Demographics and Economic Indicators • Medical Needs of the Service Area • Estimating Service Area Demand • Special Considerations 2018 Capital Link www.caplink.org 10
Market Snapshot 2018 Capital Link www.caplink.org 11
Market Snapshot Table of Contents • Introduction Individual UDS • Patient Origin HRSA UDS Website • Percentage of Low-Income Residents by Zip Code UDSMAPPER • Number of Low-Income Residents by Census Tract U.S. Census • Percent Penetration of Low Income Pop by FQHCs UDSMAPPER • Unserved Low-Income Population UDSMAPPER • About the Sources 2018 Capital Link www.caplink.org 12
Market Snapshot - Introduction • Market Snapshot Defined • Sources of Data/Graphics • Summary of Primary Service Area 2018 Capital Link www.caplink.org 13
Market Snapshot – Patient Origin • Approximately 75% of total patients is considered Primary Service Area • Next 20-25% is Secondary Service Area • HRSA UDS Website 2018 Capital Link www.caplink.org 14
Market Snapshot – Percentage of Low-Income Residents by Zip Code • Begin to Consider FQHC Total Possible Market • Illustrate Zip Code Boundaries and Primary Service Area • Identify Those Zip Codes with Highest Poverty Ratios • Identify FQHCs within Service Areas 2018 Capital Link www.caplink.org 15
Market Snapshot – Number of Low-Income Residents by Census Tract • Calculate Total Possible FQHC Market • UDSMAPPER Does Not Provide Number of Low-Income Residents • Census Tracts Typically are Smaller Geographic Area than Zip Codes; Allowing for More Specific Calculations and Planning 2018 Capital Link www.caplink.org 16
Market Snapshot – Percent Penetration Low-Income Population by FQHCs • Illustrates the Percentage of Low-Income Residents Being Served by FQHC • Identify Those Zip Codes Where FQHCs have Significant (or Little) Presence • You Know Your Patients by Zip Code – Begin to Calculate Other FQHCs’ 2018 Capital Link www.caplink.org 17
Market Snapshot – Unserved Low-Income Population • Quickly Identify Those Zip Codes in and around the Primary Service Area and Their Number of Unserved Low-Income Residents • Helps Determine and Perhaps Prioritize Outreach Methods, Intensity, and Message • Contributes to Strategic Planning • Can Help Define and Direct Goals 2018 Capital Link www.caplink.org 18
Market Snapshot – Overview • Visually Conveys - Primary Service Area (Individual FQHC Geographic Footprint) - Low-Income Population (Total Potential FQHC Market) - Low-Income Population Being Served by FQHCs (FQHC Market Penetration) - Low-Income Population Not Being Served by FQHCs (Total Potential FQHC Patients) • Good, Basic Introduction to Service Area and Market Questions • Are There Materials to Further Clarify and Address These Initial Findings and Questions? 2018 Capital Link www.caplink.org 19
Additional Data to Reduce Uncertainty & Risk? Using Data Already at Hand 2018 Capital Link www.caplink.org 20
Demographics and Economic Indicators • Compare state, county, metropolitan areas, cities, zip codes, etc. - Populations - Race - Income Ratios - Education - Language - Business Establishments and Employees by Industry - Disabilities - Many more, usually according to health center specifics 2018 Capital Link www.caplink.org 21
Medical Needs of Service Area • Compare state, county, metropolitan areas, cities, zip codes, etc. - General health indicators • Other Health Providers and Facilities • Health Professional Shortage Areas (HPSA) and MUA/Ps • Health Disparities • Selected Workforce Considerations 2018 Capital Link www.caplink.org 22
Estimating Service Area Demand • Evaluate service area market share - Populations by Various Characteristics - Payer mix • Population Projections http://www.dof.ca.gov/Forecasting/Demographics/Projections/ - Anticipate changing demographics and their effect on services and operations • Identify Additional Needs and Level of Demand • Estimating potential patients, visits, providers, capital needs 2018 Capital Link www.caplink.org 23
Market Assessment - Expansion An organization wants to consider increasing its low income population market share by 5%. How many more patients, visits, and providers would that mean? 2018 Capital Link www.caplink.org 24
Market Assessment - UDSMAPPER 15 minutes drive time from zip code 90012 in Los Angeles, California 2018 Capital Link www.caplink.org 25
Market Assessment - UDSMAPPER 15 minutes drive time from 90012 in Los Angeles, California WITH TRAFFIC CONSIDERATION 2018 Capital Link www.caplink.org 26
Market Assessment - UDSMAPPER Added layer with health center and hospital locations 2018 Capital Link www.caplink.org 27
Market Assessment - UDSMAPPER 2018 Capital Link www.caplink.org 28
Market Assessment - UDSMAPPER 2018 Capital Link www.caplink.org 29
Market Assessment - UDSMAPPER 2018 Capital Link www.caplink.org 30
Market Assessment – UDSMAPPER Data 2018 Capital Link www.caplink.org 31
US Census FactFinder 2018 Capital Link www.caplink.org 32
US Census FactFinder Geographies by census block, tract, zip code, county, state, etc. • 2018 Capital Link www.caplink.org 33
US Census FactFinder Veterans, SNAP, family structure, poverty, language, housing, • transportation, businesses (county and zip code business patterns), disability, origins, etc. 2018 Capital Link www.caplink.org 34
Policy Map 2018 Capital Link www.caplink.org 35
Policy Map - Health 2018 Capital Link www.caplink.org 36
County Health Rankings 2018 Capital Link www.caplink.org 37
County Health Rankings 2018 Capital Link www.caplink.org 38
Aunt Bertha 2018 Capital Link www.caplink.org 39
Aunt Bertha 2018 Capital Link www.caplink.org 40
Aunt Bertha 2018 Capital Link www.caplink.org 41
Back of the Envelope 2018 Capital Link www.caplink.org 42
Hypothetical Expansion Considerations Market Share – Current and Projected • Number of Patients from specific population divided by that total population • Service Area FQHC Patients = 133,390 • Service Area General Population = 714,575; Low Income Population = 425,426 • 19% market share General Population; 31% market share Low Income Population • Estimating Encounters/Visits • Historic/Realistic visits per patient times expected patients • FQHC Visits = 586,916 • 586,916 / 133,390 = 4.4 visits per patient • Projecting Workforce Needs • Historic/Realistic Provider Productivity divided by expected visits/patients • FQHC Provider FTE = 628 • FQHC Visits = 586,916 • 586,916 / 628 = 934 visits per FTE • 2018 Capital Link www.caplink.org 43
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